The Impact of Fatigue on the Quality of Life in Patients with Relapsing-Remitting Multiple Sclerosis

Abstract

Background: The main objective of this study is to determine whether fatigue in patients with RRMS is associated with a lower quality of life. The secondary objective is to examine whether clinical, demographic, and comorbid factors are associated with fatigue intensity in RRMS patients.

Methods: The study included 50 participants with confirmed diagnosis of relapsing-remitting ultiple sclerosis (RRMS). Data were collected at the Department of neurology, University hospital centre Mostar,  between January 15th and April 20th, 2025. Participants completed a structured questionnaire containing demographic data and questions related to the clinical characteristics of their disease. Fatigue levels were assessed using the Modified Fatigue Impact Scale (MFIS), while quality of life was evaluated using the Multiple Sclerosis Quality of Life-54 (MSQoL-54) questionnaire.

Main findings: Total fatigue and all its components demonstrated a strong negative correlation with all elements of quality of life (p<0.001). A higher number of relapses, higher EDSS scores, and the presence of comorbidities were significantly associated with overall fatigue and all its subtypes, while longer disease duration showed significant correlation with overall and physical fatigue. Although women had slightly higher average fatigue scores, this difference was not statistically significant. Age, marital status, and employment status were not significantly associated with fatigue levels, whereas participants with lower levels of education reported higher psychosocial fatigue (p=0.043).

Principal conclusion: The results of this study showed that fatigue had a statistically significant negative impact on the quality of life of patients with RRMS. The duration of the disease, a higher number of relapses, elevated EDSS scores, and the presence of comorbidities contributed to the development of fatigue, while sex, age, and sociodemographic factors, except for the level of education, did not show a significant influence.